Vasculitis
Vasculitis involves swelling and irritation, called inflammation, of blood vessels. The inflammation can cause the walls of the blood vessels to thicken. This thickening can narrow the vessels. If the narrowing restricts blood flow, it can damage organs and tissues.
There are many types of vasculitis. Most of them are rare. Vasculitis might affect just one organ or several. The condition can be short-term or long lasting.
Vasculitis can affect anyone. But some types are more common among people in certain age groups. Some types may improve without treatment. Most types need treatment with medicines to control the inflammation and prevent flares.
- Behcet disease
- Buerger disease
- Churg-Strauss syndrome
- Cryoglobulinemia
- Giant cell arteritis
- Granulomatosis with polyangiitis
- Henoch-Schonlein purpura
- Kawasaki disease
- Takayasu’s arteritis
Symptoms of most types of vasculitis can include:
- Fever.
- Headache.
- Tiredness.
- Weight loss.
- Aches and pains.
Other symptoms depend on the parts of the body affected:
- Digestive system. If vasculitis affects the stomach or intestines, there may be pain after eating. Ulcers and tears, called perforations, are possible. They may cause blood in the stool.
- Ears. Dizziness, ringing in the ears and sudden hearing loss may happen.
- Eyes. Vasculitis can make the eyes look red. They may itch or burn. Giant cell arteritis can cause double vision and brief or ongoing blindness in one or both eyes. This is sometimes the first sign of the disease.
- Hands or feet. Some types of vasculitis can cause numbness or weakness in a hand or foot. The palms of the hands and soles of the feet might swell or harden.
- Lungs. This can cause shortness of breath or coughing up blood.
- Skin. Bleeding under the skin can show up as red spots. Vasculitis also can cause lumps or open sores on the skin.
When to see a doctor
Make an appointment with your healthcare professional if you have symptoms that worry you. Some types of vasculitis get worse quickly. Early diagnosis is the key to getting treatment that works.
Experts don’t know the exact cause of vasculitis. Some types are linked to a person’s genes. Others result from the immune system attacking blood vessel cells by mistake. Causes of this immune system reaction may include:
- Infections, such as hepatitis B and hepatitis C.
- Blood cancers.
- Immune system diseases, such as rheumatoid arthritis, lupus and scleroderma.
- Reactions to certain medicines.
Vasculitis can happen to anyone. Factors that may increase the risk of certain types include:
- Age. Giant cell arteritis is rare before the age of 50. Kawasaki disease is most common in children younger than 5 years old.
- Family history. Behcets disease, granulomatosis with polyangiitis and Kawasaki disease can run in families.
- Lifestyle choices. Using illicit drugs such as cocaine can increase your risk of getting vasculitis. Smoking tobacco can increase risk of Buerger disease. This applies mainly to people assigned male at birth who are younger than 45.
- Medicines. Medicines such as hydralazine, allopurinol (Lopurin, Zyloprim) , minocycline (Arestin, Minocin, others) and propylthiouracil sometimes can cause vasculitis.
- Infections. Having hepatitis B or C can increase the risk of vasculitis.
- Immune conditions. People who have conditions in which their immune systems attack their own bodies by mistake may be at higher risk of vasculitis. These conditions include lupus, rheumatoid arthritis and scleroderma.
- Sex assigned at birth. Giant cell arteritis is much more common in people assigned female at birth. Buerger disease is more common in people assigned male at birth.
Vasculitis complications depend on the type of vasculitis and how bad it is. Complications also may be linked to side effects of the prescription medicines that treat the condition. Complications of vasculitis include:
- Organ damage. Some types of vasculitis can damage major organs.
- Blood clots and aneurysms. A blood clot may form in a blood vessel, blocking blood flow. Rarely, vasculitis causes a blood vessel to weaken and bulge, forming an aneurysm (AN-yoo-riz-um).
- Vision loss or blindness. This may be a complication of giant cell arteritis that isn’t treated.
- Infections. Some of the medicines used to treat vasculitis may weaken your immune system. This can make you more prone to infections.
Diagnosis starts with a medical history and a physical exam. You may have one or more tests and procedures. These can either diagnose vasculitis or rule out other conditions that cause some of the same symptoms. Tests and procedures might include:
- Blood tests. These tests look for signs of inflammation, such as a high level of C-reactive protein. A complete blood cell count can tell whether you have enough red blood cells. Other blood tests, such as the antineutrophil cytoplasmic antibody (ANCA) test, can look for certain antibodies. These tests can help diagnose vasculitis.
- Imaging tests. Imaging tests can show which blood vessels and organs are affected. They also can help your healthcare professional know how you respond to treatment. Imaging tests for vasculitis include X-rays, ultrasounds, CT scans, MRIs and positron emission tomography (PET) scans.
- X-rays of your blood vessels. During this procedure, called angiography, a flexible catheter resembling a thin straw goes into a large artery or vein. A special dye goes into the catheter. You have X-rays taken as the dye fills the artery or vein. The X-rays show the outlines of your blood vessels.
- Biopsy. This is a surgery in which a healthcare professional removes a small sample of tissue from the affected area of your body. Your health professional then looks at the tissue for signs of vasculitis.
Treatment aims to control the swelling and irritation, called inflammation. It also aims to manage the conditions that may be causing the vasculitis.
Most types of vasculitis can come back. This is called a flare. So your healthcare professional may need to follow you a long time after your symptoms go away.
Medications
A corticosteroid medicine, such as prednisone (Rayos), is the most common type of medicine prescribed to control the inflammation of vasculitis.
Corticosteroids can have bad side effects. The longer you take them, the worse the side effects may be. Side effects may include weight gain, diabetes and weakened bones. If you need a corticosteroid long-term, you get the lowest dose that will help.
Your healthcare professional may add other medicines to corticosteroids to control the inflammation. That way, you can lower the dose of corticosteroids more quickly. The medicine used depends on the type of vasculitis. Medicines may include methotrexate (Trexall), azathioprine (Imuran, Azasan), mycophenolate mofetil (CellCept), cyclophosphamide (Cytoxan), tocilizumab (Actemra) or rituximab (Rituxan).
Which medicines you need depend on the type of vasculitis you have, how bad it is, which organs are involved and any other medical problems that you have.
Surgery
Sometimes, vasculitis causes a balloonlike bulge in the wall of a blood vessel. This is called an aneurysm. This bulge may need treatment with surgery to lower the risk of it breaking. Blocked arteries also may need surgical treatment to restore blood flow to the affected area.
References
- Vasculitis. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/vasculitis. Accessed July 18, 2024.
- Ferri FF. Vasculitis, systemic. In: Ferri’s Clinical Advisor 2025. Elsevier; 2025. https://www.clinicalkey.com. Accessed July 18, 2024.
- Merkel PA. Overview of and approach to the vasculitides in adults. https://www.uptodate.com/contents/search. Accessed July 18, 2024.
- Vasculitis. American College of Rheumatology. https://rheumatology.org/patients/vasculitis. Accessed July 18, 2024.
- Merkel PA. Overview of the management of vasculitis in adults. https://www.uptodate.com/contents/search. Accessed July 18, 2024.
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